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Failure to thrive
Alternative namesFailure to thrive is a description applied to children whose current weight or rate of weight gain is significantly below that of other children of similar age and sex.
Causes, incidence, and risk factors
Failure to thrive in infants and children is usually noticed when they seem to be dramatically smaller or shorter than other children the same age. Teenagers, for example, may have short stature or appear to lack the usual changes that occur at puberty. However, there is a wide variation in normal growth and development . In general, the rate of change in weight and height may be a better indicator of a problem than the actual measurements.
There are multiple medical causes of failure to thrive that will disturb the body's metabolism enough to result in delayed growth . These include:
Psychological and social causes may include emotional deprivation as a result of parental withdrawal, rejection, or hostility.
Economic factors can affect nutrition, living conditions, and parental attitudes. Environmental factors may include exposure to infections, parasites, or toxins . Sometimes the cause of failure to thrive is simply poor eating habits, such as eating in front of the television and not having formal meal times. Many times the cause cannot be determined.
Signs and testsA physical examination is done, including height, weight and body proportions. A detailed history is taken, including prenatal, birth, neonatal, psychosocial and family information. A Denver Developmental Screening Test reveals delayed development. A growth chart including all growth parameters and trends since birth is plotted.
The following laboratory tests may be performed:
The treatment depends on the cause of the delayed growth and development. Delayed growth due to nutritional factors can be resolved by a well-balanced diet and educating the parents.
If psychosocial factors are involved, treatment should include improving the family dynamics and living conditions. Parental attitudes and behavior may contribute to a child's problems and need to be examined. In many cases, a child may need to be hospitalized initially to focus on implementation of a comprehensive medical, behavioral, and psychosocial treatment plan.
Do not give your child dietary supplements like Boost or Ensure without consulting your physician first.
Expectations (prognosis)If the period of failure to thrive has been short, and the cause is determined and can be corrected, normal growth and development will resume. If failure to thrive is prolonged, the effects may be long lasting, and normal growth and development may not be achieved.
ComplicationsPermanent mental, emotional or physical delays can occur.
Calling your health care providerCall for an appointment with your health care provider if your child does not seem to be developing normally.
PreventionThe best means of prevention is by early detection at routine well-baby examinations and periodic follow-up with school-age and adolescent children.
Update Date: 11/3/2002Philip L. Graham III, M.D., F.A.A.P., Department of Pediatrics, Children's Hospital of New York, Columbia University, New York, NY. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT